United States District Court, W.D. Virginia, Roanoke Division
Glen E. Conrad Senior United States District Judge
has filed this action challenging the final decision of the
Commissioner of Social Security denying plaintiff s claim for
a period of disability and disability insurance benefits
under the Social Security Act, as amended, 42 U.S.C.
§§ 416(i) and 423. Jurisdiction of this court is
established pursuant to 42 U.S.C. § 405(g). As reflected
by the memoranda and argument submitted by the parties, the
issues now before the court are whether the
Commissioner's final decision is supported by substantial
evidence, or whether there is "good cause" to
necessitate remanding the case to the Commissioner for
further consideration. See 42 U.S.C. § 405(g).
plaintiff, William David Hurst, was born on February 26,
1974. He completed his high school education and eventually
graduated from college. (Tr. 39). Mr. Hurst has been employed
as a hospital cleaner, security guard, and custodian. He
worked for a contract cleaning service for part of 2015 and
2016 with the assistance of a job coach. (Tr. 17, 200, 278).
However, the Administrative Law Judge determined that such
employment did not reach the level of substantial gainful
activity. (Tr. 17).
September 26, 2013, Mr. Hurst filed an application for a
period of disability and disability insurance benefits. In
filing his current claim, Mr. Hurst alleged that he became
disabled for all forms of substantial gainful employment on
September 19, 2013, due to Asperger's syndrome, attention
deficit hyperactivity disorder (ADHD), and insomnia. (Tr.
205). Mr. Hurst now maintains that he has remained disabled
to the present time. The record reveals that Mr. Hurst met
the insured status requirements of the Act at all relevant
times covered by the final decision of the Commissioner. See
generally 42 U.S.C. §§ 416(i) and 423(a).
Hurst's application was denied upon initial consideration
and reconsideration. He then requested and received a de
novo hearing and review before an Administrative Law
Judge. In an opinion dated November 2, 2016, the Law Judge
also determined, after applying the five-step sequential
evaluation process, that Mr. Hurst is not disabled. See 20
C.F.R. § 404.1520. The Law Judge found that Mr. Hurst
suffers from several severe impairments, including
Asperger's syndrome, ADHD, hearing loss, depression, and
anxiety, but that these impairments do not, either
individually or in combination, meet or medically equal the
requirements of a listed impairment. (Tr. 17-18). The Law
Judge then assessed Mr. Hurst's residual functional
capacity as follows:
After careful consideration of the entire record, the
undersigned finds that the claimant has the residual
functional capacity to perform a full range of work at all
exertional levels but with the following nonexertional
limitations: the claimant is able to understand, remember and
carry out simple instructions in repetitive unskilled work.
He should have no interaction with the general public and no
more than occasional interaction with co-workers and
supervisors. He would be able to respond appropriately to
supervision, co-workers, and usual work situations. He should
avoid fast-paced environments like those on an assembly line.
He should have static job duties that remain fairly constant
and avoid exposure to excessively loud background noise such
as heavy traffic and jackhammers/construction equipment in
the immediate work environment.
(Tr. 20). Given such a residual functional capacity, and
after considering the testimony of a vocational expert, the
Law Judge determined that Mr. Hurst is unable to perform any
of his past relevant work. (Tr. 24). However, the Law Judge
found that Mr. Hurst retains sufficient functional capacity
to perform other work roles existing in significant number in
the national economy. (Tr. 25). Accordingly, the Law Judge
concluded that Mr. Hurst is not disabled, and that he is not
entitled to a period of disability or disability insurance
benefits. See 20 C.F.R. § 404.1520(g). The Law
Judge's opinion was adopted as the final decision of the
Commissioner by the Social Security Administration's
Appeals Council. Having exhausted all available
administrative remedies, Mr. Hurst has now appealed to this
plaintiff may be disabled for certain forms of employment,
the crucial factual determination is whether plaintiff is
disabled for all forms of substantial gainful employment.
See 42 U.S.C. § 423(d)(2). There are four
elements of proof which must be considered in making such an
analysis. These elements are summarized as follows: (1)
objective medical facts and clinical findings; (2) the
opinions and conclusions of treating physicians; (3)
subjective evidence of physical manifestations of
impairments, as described through a claimant's testimony;
and (4) the claimant's education, vocational history,
residual skills, and age. Vitek v. Finch, 438 F.2d
1157, 1159-60 (4th Cir. 1971); Underwood v.
Ribicoff, 298 F.2d 850, 851 (4th Cir. 1962).
appeal, Mr. Hurst raises several arguments, including that
the Law Judge improperly assessed the opinion evidence and
erred in determining his residual functional capacity. After
reviewing the record and considering the parties'
arguments, the court finds "good cause" to remand
the case to the Commissioner for further development and
consideration. See 42 U.S.C. § 405(g).
medical record establishes that Mr. Hurst suffers from a
combination of severe nonexertional impairments. In September
of 2012, Dr. George Wagner, a physician with New Horizons
Healthcare, diagnosed plaintiff with ADHD and insomnia. (Tr.
311). He prescribed trazodone, an antidepressant, which
plaintiff continued to take at the time of the administrative
hearing. (Tr. 46, 311). On November 12, 2013, Mr. Hurst
presented to Dr. Alan Katz, a clinical psychologist, for a
neuropsychological evaluation. (Tr. 321). Dr. Katz, who had
previously evaluated plaintiff in 2001, noted that plaintiff
has "a longstanding history of social anxiety that has
been complicated by intermittent episodes of poorly modulated
anger and reduced social judgment." (Tr. 321). Dr. Katz
also noted that plaintiff exhibits "classic
manifestations" of autism spectrum disorder or
Asperger's syndrome, such as "social awkwardness,
decreased insight and a non-verbal learning disability,"
and that other "complicating factors" include
"lifelong depression, reduced stress tolerance and fears
about his ability to maintain independent living." (Tr.
321). Based on clinical interviews, his review of existing
records, and the results of a series of questionnaires and
tests, Dr. Katz diagnosed plaintiff with autism spectrum
disorder, Asperger's syndrome, a visual impairment, and
right fronto-parietal deficits. (Tr. 327). More recent
treatment records from New Horizons Healthcare also reflect
diagnoses of Asperger's syndrome and depression, as well
as moderate hearing loss in both ears. (Tr. 389, 400, 404,
record contains several opinions regarding the impact of Mr.
Hurst's impairments on his ability to work. At the
conclusion of the initial neuropsychological evaluation, Dr.
Katz noted that Mr. Hurst "would be well served by an
application for Social Security benefits," but that he
remained hopeful that plaintiffs "acquisition of
benefits of this type [would] prove to be a temporary
arrangement," since employment would be "the
healthiest of all possibilities." (Tr. 326). Dr. Katz
recommended that plaintiff "initiate contact with the
Department of Aging and Rehabilitative Services for ...
assistance with job exploration, interviewing skills and a
possible position of supported employment." (Tr. 326).
On December 5, 2013, plaintiff returned to Dr. Katz for a
follow-up appointment, during which plaintiff expressed
frustration "due to his unemployment status." (Tr.
328). At that point, Dr. Katz opined that plaintiff
"would be best served by at least short term disability
support from Social Security given the host of social,
emotional and neurocognitive deficits he continues to
display." (Tr. 328). However, he urged Mr. Hurst
"to continue to pursue a position of highly structured,
repetitive and supervised employment where he can work at a
reduced pace and without social and interpersonal demands
being placed upon him." (Tr. 328).
state agency psychologists, Dr. Joseph Leizer and Dr. Linda
Dougherty, completed two forms regarding plaintiffs mental
health: a Psychiatric Review Technique form and a Mental
Residual Functional Capacity Assessment form. On the latter
form, both psychologists noted that Mr. Hurst has marked or
moderate limitations in the categories of "sustained
concentration and persistence," "social
interaction," and "adaptation," but that he
"should be able to perform the basic mental demands of
simple and low stress competitive work on a sustained
basis." (Tr. 75-77, 88-90). Like Dr. Katz, however, the
state agency psychologists also indicated that plaintiff
would require a heightened level of supervision as a result
of his impairments. When asked to explain, in narrative form,
the resulting limitations in the area of sustained
concentration and persistence, they stated as follows:
The claimant can concentrate and persist at simple job
instructions and duties, make simple decisions, sustain
ordinary routines with occasional extra supervisory
help, maintain usual attendance requirements, work
around others without being unduly ...